Hybrid LTSS Service Coordinator – RN Clinician, RN Case Manager

at Elevance Health

• Job title: LTSS Service Coordinator – RN Clinician, RN Case Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Troy, United States

About the role

• LTSS Service Coordinator responsible for member care plan management and coordination for Ohio health plan. Performing assessments and collaborating with healthcare teams to optimize member care.

Responsibilities

• Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs
• Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team
• Manages members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of health benefits
• Obtains a thorough and accurate member history to develop an individual care plan
• Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs
• The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services
• May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible
• Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans
• May also assist in problem solving with providers, claims or service issues.

Requirements

• Requires a high school diploma or GED equivalent
• minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role
• Current, active valid and unrestricted RN license in Ohio state(s) required.
• BA/BS in Health/Nursing preferred.
• Strong preference for case management experience with older adults or individuals with disabilities.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources